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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. BAK 0139905
Regular
Dec 21, 2007

JOSE DE JESUS ZEPEDA (JOSE DE JESUS ZEPEDA MARTINEZ) vs. ARTS CUSTOM CABINETS, AACA/AMERICAN COMMERCIAL CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration of a Findings and Award concerning lien claimant's facility fees. The Board found the record insufficient to determine if the discogram and discectomy were reasonable and necessary treatments for the applicant's industrial injury. The case is returned to the trial level for further development of the medical record, including addressing ACOEM guidelines and the reasonableness of surgical center fees.

Lien claimantReconsiderationFindings and AwardFacility feesEpidural injectionsDiscogramDiscectomyHerniated nucleus pulposusReasonable and necessaryMedical evidence
References
Case No. ADJ1498865 (WCK 0071162) ADJ3989369 (WCK 0071163)
Regular
Sep 20, 2013

Michelle Livengood vs. State of California, National Union Fire Insurance Company

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of a decision terminating temporary disability benefits. The applicant's medical condition stemming from three 2000 injuries has been complex, with a history of extensive litigation. The Administrative Law Judge found no evidence of ongoing temporary disability, concluding the applicant's condition was permanent and stationary. The Board adopted the judge's reasoning, denying reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability IndemnityPark AideSomatoform ReactionMedical EvaluationNeurological ConsultationDiscogramEEGOphthalmological Evaluation
References
Case No. ADJ1498865 (WCK 0071162) ADJ3989369 (WCK 0071163) ADJ2618113 (WCK 0071164)
Regular
Jul 09, 2010

MICHELLE LIVENGOOD vs. MT. DIABLO STATE PARK (CALIFORNIA DEPARTMENT OF PARKS AND RECREATION) and AIG

This case concerns Michelle Livengood's multiple industrial injuries. The Court of Appeal found contradictory findings regarding her permanent and stationary status, remanding the case for clarification. The Appeals Board has now granted reconsideration, affirmed the original findings but deferred the issue of temporary disability. The matter is returned to the trial level for further proceedings to clarify if the neurological consultation was diagnostic, which would necessitate a finding of not permanent and stationary.

Workers' Compensation Appeals BoardRemittiturPermanent and StationaryTemporary DisabilityNeurological ConsultationDiscogramQualified Medical EvaluatorPetition for ReconsiderationWrit of ReviewSubstantial Evidence
References
Case No. ADJ4523497 (AHM 0062594) ADJ488115 (AHM 0062669)
Regular
Jan 09, 2014

Anthony Becker vs. American Drug Stores, Broadspire

The Workers' Compensation Appeals Board denied reconsideration of a decision that apportioned 25% of the applicant's permanent spinal disability to non-industrial factors. The applicant argued that the Agreed Medical Examiner established his permanent total disability was solely due to surgeries for industrial cumulative trauma. However, the Board found the defendant met its burden of proof for apportionment, as the AME's testimony supported that the applicant's pre-existing spondylolisthesis contributed to the need for two-level spinal surgery. The Board adopted the WCJ's report and affirmed the original award.

WCABPetition for ReconsiderationJoint Findings and AwardCumulative TraumaApportionmentNon-industrial factorsAgreed Medical Examiner (AME)Escobedo v. MarshallsSpondylolisthesisPreexisting developmental anomaly
References
Case No. SAC 286368
Regular
Jan 25, 2008

DALE OLIVER vs. BRIAN WILLIAMS CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

This case involves an applicant seeking approval for disc replacement surgery for a work-related back injury. The defendant argued the surgery is experimental per ACOEM guidelines, thus not covered. The Board denied reconsideration, finding the applicant's physician rebutted the presumption of experimental status. The Board determined the surgery is no longer experimental, citing FDA approval, and is reasonably required for the applicant's specific condition, supported by expert medical opinion.

Workers' Compensation Appeals BoardBrian Williams ConstructionState Compensation Insurance Fundindustrial injuryright anklefootelbowshoulderskneesleft lower extremity
References
Case No. LAO 799279
Regular
Sep 07, 2007

RUBEN BALCON vs. RADIANT SERVICES CORP., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to allow a lien claimant, BHCAOS, to present its claim for unpaid outpatient facility fees. The Board found that the defendant had notice of the lien early on and that the lien claimant should have an opportunity to prove timely filing and service of its claim. The case was returned to the trial level for full consideration of the lien.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and OrderOutpatient Facility FeesTimelinessLabor Code section 4904Newly Discovered EvidenceCompromise and Release AgreementFictitious Name Permit
References
Case No. SFO 0488825
Regular
Dec 14, 2007

MARK HURLEY vs. STEELCASE, INC. (METRO FURNITURE), LIBERTY MUTUAL INSURANCE COMPANY

This case involves a workers' compensation applicant injured in 2000 who claimed temporary total disability (TTD) beginning in 2005. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, overturning the WCJ's denial of TTD from December 5, 2005, through the present. The WCAB found that the agreed medical evaluator's opinion supported the applicant's claim that the industrial injury caused TTD from that date forward.

Workers Compensation Appeals BoardSteelcase Inc.Liberty Mutual Insurance CompanyMark HurleySFO 0488825Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and AwardAdministrative Law Judge (WCJ)Industrial Injury
References
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